Individual
JULIE M HARRIS
Active
Individual
JULIE M HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7959
KY
174400000X
Specialist
7959
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50002288
PASSPORT
KY
01
—
60002508
MEDICAID - DENTAL
KY
05
—
64073760
—
KY
Enumeration date
08/09/2005
Last updated
01/09/2008
Update your record
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